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Early in my third year, I was working to identify my future career. In my search I often found myself asking physicians why they chose their specialty. The question was aimed broadly as I hoped to grasp how different specialties thought and viewed their field. The most impactful answer came from a gastrointestinal surgeon. He was blunt and honest when he answered. He stated his field was not glamorous, but he found great satisfaction in being an end point for a problem. He explained that he was expected to solve the problems presented to him; it was not expected for him to refer further because he was the specialist. Patients needed his expertise, and he enjoyed being an expert in a field that was needed to improve outcomes.
From there, I began to think of specialties in terms of endpoints and what patient needs do not go beyond that specialty. These endpoints are of most importance as they are ultimately what, a physician will need to be able to handle on a daily basis. When it came to anesthesia, I reflected on my experience and thought of endpoints.
Through reflection and the advice of others I settled on the broad category of crisis management for Anesthesia’s endpoint. Most students interested in Anesthesiology have heard the phrase or some iteration of “Hours of boredom, moments of terror” applied to the specialty. Modern Anesthesia is very safe, but in fact these moments of terror do occur. That is the end point of practicing Anesthesiologists in my opinion. In operating rooms occasionally things deviate from the optimal path and it is the job of the Anesthesia team to correct this deviation. This endpoint is in reality many things. Crisis management in the operating room could include hemorrhage, thyroid storm, electrolyte abnormalities, or any other alteration. There are innumerable things that could lead to crisis; it is the Anesthesiologist’s job to be prepared to react to these situations. This requires more than medical knowledge as Anesthesiologists must coordinate with other professionals within the operating room, and management the equipment necessary to maintain patient safety. This is a tall task, but when performed correctly leads to better outcomes for patients.
Many of us entered medicine to solve problems for patients. For me, analysis of the endpoints offered a simple framework to focus on the tasks of patient care for each specialty. Moreover, it allows you to think about what makes that specialty essential to healthcare. I chose to apply to Anesthesia because the endpoints I saw in practice greatly impacted the outcomes for patients. Every specialty offers value to patients in their own way, but it is important, in my opinion, to identify the tasks and responsibilities expected from each specialty as part of identifying a future career.
Citation: Pardo M. Crisis Management in Anesthesiology, 2nd Edition. Anesthesiology. 2016;124(3):3 7.doi:10.1097/aln.0000000000000991.
posted August 25, 2020
